Hematological abnormalities and the use of granulocyte-colony-stimulating factor in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis
Hematological abnormalities and the use of granulocyte-colony-stimulating factor in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis
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DOI：
10.1111/j.1365-4632.2011.05007.x
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发表时间：
2011-12-01
影响因子：
3.6
通讯作者：
Tay, Yong-Kwang
中科院分区：
文献类型：
--
作者：
Ang, Chia-Chun;Tay, Yong-Kwang
背景 史蒂文斯约翰逊综合征 (SJS) 和中毒性表皮坏死松解症 (TEN) 患者的血细胞计数紊乱已被描述，但尚未得到充分表征。我们的目的是描述患者血液学结果与疾病演变之间的关系，并假设粒细胞集落刺激因子（G-CSF）在治疗这些疾病中可能发挥的作用。材料和方法分析了 2005 年 1 月至 2010 年 SJS 和 TEN 患者的临床记录。结果贫血和淋巴细胞减少症最常见，血小板减少症不常见。白细胞减少和中性粒细胞减少见于病情较严重的患者，白细胞减少和中性粒细胞减少的趋势随疾病的演变而变化。两名患者因发热性中性粒细胞减少症接受 G-CSF 治疗，中性粒细胞计数迅速恢复，上皮细胞再形成时间也更短。 结论 我们的患者倾向于出现白细胞减少症和中性粒细胞减少症，根据疾病的阶段，其遵循可预测的下降趋势并随后改善。这可能具有致病意义，在这些病例中可以使用 G-CSF 来控制发热性中性粒细胞减少症并帮助上皮细胞再生。需要进一步的基础科学研究来证明我们的假设。
Background Derangements in blood cell counts have been described in patients with StevensJohnson syndrome (SJS) and toxic epidermal necrolysis (TEN) but are not well characterized. We aim to describe the relationship between our patients hematological results and the evolution of disease and hypothesize on the possible roles of granulocyte-colony-stimulating factor (G-CSF) in the management of these conditions.Materials and methods Clinical records of our patients with SJS and TEN from January 2005 to 2010 were analyzed.Results Anemia and lymphopenia were most commonly seen, while thrombocytopenia was uncommon. Leukopenia and neutropenia were seen in patients with more severe disease, and the trend of leukopenia and neutropenia followed the evolution of disease. Two patients received G-CSF for febrile neutropenia and had a rapid recovery of their neutrophil counts as well as a shorter time to re-epithelialization.Conclusion Our patients tended to have leukopenia and neutropenia that followed a predictable trend of decline and subsequent improvement depending on the stage of disease. This may be of pathogenic significance, and G-CSF may be used in these cases to manage febrile neutropenia and aid re-epithelialization. Further basic science research is required to prove our hypotheses.